An assessment was made of the frequency of liver cell dysplasia and the mean age of each group in 56 normal, 13 cirrhotic, and 50 hepatocellular carcinoma (HCC) patients, 40 with cirrhosis, from southern Africa. Dysplasia increased from 7.1% in normal subjects to 38.5% in cirrhotic, 40% in noncirrhotic HCC, and 52.5% in cirrhotic HCC patients, three statistically similar frequencies. Average patient ages were as follows: patients with normal livers, 37.3 years; with cirrhosis, 42.4 years; with noncirrhotic HCC, 36.5 years; and with cirrhotic HCC, 34 years, the mean age with dysplasia being lower than that of the whole group. With no increase in frequency of dysplasia from cirrhosis to HCC with cirrhosis, with a similar high frequency in HCC without cirrhosis, and with a mean age of all HCC patients 8 years less than that of cirrhotics and 3 years less than normals, chronologic evolutionary progression from cirrhosis to dysplasia to HCC in southern Africa cannot be demonstrated.
Cancer 5731535-1538, 1986.
IVER CELL DYSPLASIA in Ugandan patients was first L described by Anthony et al.' who noted its increasing frequency from normal to cirrhotic livers, to cirrhotic liv- ers with hepatocellular carcinoma (HCC). They also discerned a possible chronologic progression from cirrhosis to dysplasia to HCC, similar to the cellular evolution from initiated preneoplastic hepatocytes to HCC suggested by experimental hepatocarcinogenesis.2 In a previous study,3 however, we found that the frequency of dysplasia in southern African HCC patients was high whether cirrhosis was present or not, implying no constant progression through cirrhosis and dysplasia to HCC. This lack of chronologic evolutionary progression was also noted by Sakurai4 in Japan. In order to better demonstrate possible chronologic progression, we assessed the frequency of liver cell dysplasia in southern African patients with normal and cirrhotic livers. These frequencies and the mean age of each group were compared to those of patients with HCC.
Materials and Methods
Hematoxylin and eosin-stained autopsy non-neoplastic liver tissue from 56 black southern African males with